Surgical clip applier with parallel closure jaws

ABSTRACT

An end effector for a surgical clip applier includes a housing, and jaws that extend past a distal end of the housing and include opposed first and second jaw members each comprising an independent structure movable relative to the other. The first jaw member defines a first inner surface and the second jaw member defines a second inner surface opposite the first inner surface. An actuation mechanism is operatively coupled to the jaw members and operable to move the jaws between an open position and a closed position. The first and second inner surfaces remain substantially parallel to each other as the jaws move between the open and closed positions.

BACKGROUND

Minimally invasive surgical (MIS) tools and procedures are oftenpreferred over traditional open surgical approaches due to theirpropensity toward reducing post-operative recovery time and leavingminimal scarring. Endoscopic surgery is one type of MIS procedure inwhich a surgical tool operably connected to an elongate shaft isintroduced into the body of a patient through a natural bodily orifice.Laparoscopic surgery is a related type of MIS procedure in which a smallincision is formed in the abdomen of a patient and a trocar is insertedthrough the incision to form a surgical access pathway for a surgicaltool and elongate shaft. Once located within the abdomen, the surgicaltool engages and/or treats tissue in a number of ways to achieve adiagnostic or therapeutic effect. Manipulation and engagement of thesurgical tool may take place via various components passing through theelongate shaft.

One surgical instrument commonly used with a trocar is a surgical clipapplier, which can be used to ligate blood vessels, ducts, shunts, orportions of body tissue during surgery. Traditional surgical clipappliers have a handle and an elongate shaft extending from the handle.A pair of movable opposed jaws is positioned at the end of the elongateshaft for holding and forming a surgical clip or “ligation clip”therebetween. In operation, a user (e.g., a surgeon or clinician)positions the jaws around the vessel or duct and squeezes a trigger onthe handle to close the jaws and thereby collapse the surgical clip overthe vessel.

More recently, however, robotic systems have been developed to assist inMIS procedures. Instead of directly engaging a surgical instrument,users are now able to manipulate and engage surgical instruments via anelectronic interface communicatively coupled to a robotic manipulator.With the advances of robotic surgery, a user need not even be in theoperating room with the patient during the surgery.

Robotic surgical systems are also now capable of utilizing roboticallycontrolled clip appliers. Such clip appliers include features forrobotically feeding and forming surgical clips. Advances andimprovements to the methods and devices for applying surgical clips tovessels, ducts, shunts, etc. is continuously in demand to make theprocess more efficient and safe.

BRIEF DESCRIPTION OF THE DRAWINGS

The following figures are included to illustrate certain aspects of thepresent disclosure, and should not be viewed as exclusive embodiments.The subject matter disclosed is capable of considerable modifications,alterations, combinations, and equivalents in form and function, withoutdeparting from the scope of this disclosure.

FIG. 1 is a block diagram of an example robotic surgical system that mayincorporate some or all of the principles of the present disclosure.

FIG. 2 is an isometric top view of an example surgical tool that mayincorporate some or all of the principles of the present disclosure.

FIG. 3 is an isometric bottom view of the surgical tool of FIG. 2.

FIG. 4 is an exploded view of the elongate shaft and the end effector ofthe surgical tool of FIGS. 2 and 3.

FIG. 5 is an exposed isometric view of the surgical tool of FIG. 2.

FIG. 6 is an enlarged, isometric view of one example of the jaws of FIG.8.

FIG. 7 is an enlarged isometric view of one example of the cam of FIG.8.

FIG. 8 is an isometric view of one example of the push rod of FIG. 8.

FIGS. 9A and 9B illustrate example operation of the cam and the jaws.

FIGS. 10A and 10B are isometric views of an example end effector thatmay incorporate the principles of the present disclosure.

FIG. 10C is an isometric view of an alternative embodiment of the endeffector of FIGS. 10A-10B.

FIGS. 11A and 11B are partial cross-sectional views of another exampleend effector that may incorporate the principles of the presentdisclosure.

FIG. 12A is a partial isometric view of another example end effectorthat may incorporate the principles of the present disclosure

FIGS. 12B and 12C are top views of the jaws of FIG. 12A in the open andclosed positions.

FIG. 12D is a side view of the actuation plate of FIG. 12A.

FIG. 12E is an isometric view of the end effector of FIG. 12A with thejaws in the closed position.

DETAILED DESCRIPTION

The present disclosure is related to surgical systems and, moreparticularly, to surgical clip appliers with improved jaws thatfacilitate parallel closure of opposed jaw members.

Embodiments discussed herein describe improvements to end effector jawsused in surgical clip appliers. As described herein, an end effector mayinclude a housing and jaws may extend out a distal end of the housing.The jaws include opposed first and second jaw members, each comprisingan independent structure that is movable relative to the other. Thefirst and second jaw members each define opposing inner surfaces and anactuation mechanism may be operatively coupled to the jaw members totransition the jaws between an open position and a closed position.Since the jaw members comprise independent and separate structures, theopposing inner surfaces are able to remain parallel to each other as thejaws move between the open and closed positions and thereby achieveparallel closure.

FIG. 1 is a block diagram of an example robotic surgical system 100 thatmay incorporate some or all of the principles of the present disclosure.As illustrated, the system 100 can include at least one mastercontroller 102 a and at least one arm cart 104. The arm cart 104 may bemechanically and/or electrically coupled to a robotic manipulator and,more particularly, to one or more robotic arms 106 or “tool drivers”.Each robotic arm 106 may include and otherwise provide a location formounting one or more surgical tools or instruments 108 for performingvarious surgical tasks on a patient 110. Operation of the robotic arms106 and instruments 108 may be directed by a clinician 112 a (e.g., asurgeon) from the master controller 102 a.

In some embodiments, a second master controller 102 b (shown in dashedlines) operated by a second clinician 112 b may also direct operation ofthe robotic arms 106 and instruments 108 in conjunction with the firstclinician 112 a. In such embodiments, for example, each clinician 102a,b may control different robotic arms 106 or, in some cases, completecontrol of the robotic arms 106 may be passed between the clinicians 102a,b. In some embodiments, additional arm carts (not shown) havingadditional robotic arms (not shown) may be utilized during surgery on apatient 110, and these additional robotic arms may be controlled by oneor more of the master controllers 102 a,b.

The arm cart 104 and the master controllers 102 a,b may be incommunication with one another via a communications link 114, which maybe any type of wired or wireless telecommunications means configured tocarry a variety of communication signals (e.g., electrical, optical,infrared, etc.) according to any communications protocol.

The master controllers 102 a,b generally include one or more physicalcontrollers that can be grasped by the clinicians 112 a,b andmanipulated in space while the surgeon views the procedure via a stereodisplay. The physical controllers generally comprise manual inputdevices movable in multiple degrees of freedom, and which often includean actuatable handle for actuating the surgical instrument(s) 108, forexample, for opening and closing opposing jaws, applying an electricalpotential (current) to an electrode, or the like. The master controllers102 a,b can also include an optional feedback meter viewable by theclinicians 112 a,b via a display to provide a visual indication ofvarious surgical instrument metrics, such as the amount of force beingapplied to the surgical instrument (i.e., a cutting instrument ordynamic clamping member).

Example implementations of robotic surgical systems, such as the system100, are disclosed in U.S. Pat. No. 7,524,320, the contents of which areincorporated herein by reference. The various particularities of suchdevices will not be described in detail herein beyond that which may benecessary to understand the various embodiments and forms of the variousembodiments of robotic surgery apparatus, systems, and methods disclosedherein.

FIG. 2 is an isometric top view of an example surgical tool 200 that mayincorporate some or all of the principles of the present disclosure. Thesurgical tool 200 may be the same as or similar to the surgicalinstrument(s) 108 of FIG. 1 and, therefore, may be used in conjunctionwith the robotic surgical system 100 of FIG. 1. Accordingly, thesurgical tool 200 may be designed to be releasably coupled to a roboticarm 106 (FIG. 1) of a robotic manipulator of the robotic surgical system100. Full detail and operational description of the surgical tool 200 isprovided in U.S. Patent Pub. 2016/0287252, entitled “Clip ApplierAdapted for Use with a Surgical Robot,” the contents of which are herebyincorporated by reference in their entirety.

While the surgical tool 200 is described herein with reference to arobotic surgical system, it is noted that the principles of the presentdisclosure are equally applicable to non-robotic surgical tools or, morespecifically, manually operated surgical tools. Accordingly, thediscussion provided herein relating to robotic surgical systems merelyencompasses one example application of the presently disclosed inventiveconcepts.

As illustrated, the surgical tool 200 can include an elongate shaft 202,an end effector 204 coupled to the distal end of the shaft 202, and adrive housing 206 coupled to the proximal end of the shaft 202. Theterms “proximal” and “distal” are defined herein relative to a roboticsurgical system having an interface configured to mechanically andelectrically couple the surgical tool 200 (e.g., the drive housing 206)to a robotic manipulator. The term “proximal” refers to the position ofan element closer to the robotic manipulator and the term “distal”refers to the position of an element closer to the end effector 204 andthus further away from the robotic manipulator. Moreover, the use ofdirectional terms such as above, below, upper, lower, upward, downward,left, right, and the like are used in relation to the illustrativeembodiments as they are depicted in the figures, the upward or upperdirection being toward the top of the corresponding figure and thedownward or lower direction being toward the bottom of the correspondingfigure.

In applications where the surgical tool 200 is used in conjunction witha robotic surgical system (e.g., system 100 of FIG. 1), the drivehousing 206 can include a tool mounting portion 208 designed withfeatures that releasably couple the surgical tool 200 to a robotic arm(e.g., the robotic arms 106 or “tool drivers” of FIG. 1) of a roboticmanipulator. The tool mounting portion 208 may releasably attach(couple) the drive housing 206 to a tool driver in a variety of ways,such as by clamping thereto, clipping thereto, or slidably matingtherewith. In some embodiments, the tool mounting portion 208 mayinclude an array of electrical connecting pins, which may be coupled toan electrical connection on the mounting surface of the tool driver.While the tool mounting portion 208 is described herein with referenceto mechanical, electrical, and magnetic coupling elements, it should beunderstood that a wide variety of telemetry modalities might be used,including infrared, inductive coupling, or the like.

FIG. 3 is an isometric bottom view of the surgical tool 200. Thesurgical tool 200 further includes an interface 302 that mechanicallyand electrically couples the tool mounting portion 208 to a roboticmanipulator. In various embodiments, the tool mounting portion 208includes a tool mounting plate 304 that operably supports a plurality ofdrive inputs, shown as a first drive input 306 a, a second drive input306 b, and a third drive input 306 c. While only three drive inputs 306a-c are shown in FIG. 3, more or less than three may be employed,without departing from the scope of the disclosure.

In the illustrated embodiment, each drive input 306 a-c comprises arotatable disc configured to align with and couple to a correspondinginput actuator (not shown) of a given tool driver. Moreover, each driveinput 306 a-c provides or defines one or more surface features 308configured to align with mating surface features provided on thecorresponding input actuator. The surface features 308 can include, forexample, various protrusions and/or indentations that facilitate amating engagement.

FIG. 4 is an exploded view of one example of the elongate shaft 202 andthe end effector 204 of the surgical tool 200 of FIGS. 2 and 3,according to one or more embodiments. As illustrated, the shaft 202includes an outer tube 402 that houses the various components of theshaft 202, which can include a jaw retaining assembly 404. The jawretaining assembly 404 includes a jaw retainer shaft 406 with a cliptrack 408 and a push rod channel 410 formed thereon. The end effector204 includes opposing jaws 412 that are configured to mate to a distalend of the clip track 408.

The shaft 202 also includes a clip advancing assembly, which, in oneexample embodiment, can include a feeder shoe 414 adapted to be slidablydisposed within the clip track 408. The feeder shoe 414 is designed toadvance a series of clips 416 positioned within the clip track 408, anda feedbar 418 is adapted to drive the feeder shoe 414 through the cliptrack 408. An advancer assembly 420 is adapted to mate to a distal endof the feedbar 418 for advancing a distal-most clip into the jaws 412.

The shaft 202 furthers include a clip forming or camming assemblyoperable to collapse the jaws 412 and thereby crimp (crush) a surgicalclip 416 positioned between (interposing) the jaws 412. The cammingassembly includes a cam 422 that slidably mates to the jaws 412, and apush rod 424 that moves the cam 422 relative to the jaws 412 to collapsethe jaws 412. A tissue stop 426 can mate to a distal end of the cliptrack 408 to help position the jaws 412 relative to a surgical site.

The jaw retainer shaft 406 is extendable within and couples to the outertube 402 at a proximal end 428 a, and its distal end 428 b is adapted tomate with the jaws 412. The push rod channel 410 formed on the jawretainer shaft 406 may be configured to slidably receive the push rod424, which is used to advance the cam 422 over the jaws 412. The cliptrack 408 extends distally beyond the distal end 428 b of the jawretainer shaft 406 to allow a distal end of the clip track 408 to besubstantially aligned with the jaws 412.

The clip track 408 can include several openings 430 formed therein forreceiving an upper or “superior” tang 432 a formed on the feeder shoe414 adapted to be disposed within the clip track 408. The clip track 408can also include a stop tang 434 formed thereon that is effective to beengaged by a corresponding stop tang formed on the feeder shoe 414 toprevent movement of the feeder shoe 414 beyond a distal-most position.To facilitate proximal movement of the feeder shoe 414 within the cliptrack 408, the feeder shoe 414 can also include a lower or “inferior”tang 432 b formed on the underside thereof for allowing the feeder shoe414 to be engaged by the feedbar 418 as the feedbar 418 is moveddistally. In use, each time the feedbar 418 is moved distally, a detentformed in the feedbar 418 engages the inferior tang 432 b and moves thefeeder shoe 414 distally a predetermined distance within the clip track408. The feedbar 418 can then be moved proximally to return to itsinitial position, and the angle of the inferior tang 432 b allows theinferior tang 432 b to slide into the next detent formed in the feedbar418.

The jaws 412 include first and second opposed jaw members that aremovable (collapsible) relative to one another and are configured toreceive a surgical clip from the series of clips 416 therebetween. Thejaw members can each include a groove formed on opposed inner surfacesthereof for receiving the legs of a surgical clip 416 in alignment withthe jaw members. In the illustrated embodiment, the jaw members arebiased to an open position and a force is required to urge the jawmembers toward one another to crimp the interposing clip 416. The jawmembers can also each include a cam track formed thereon for allowingthe cam 422 to slidably engage and move the jaw members toward oneanother. A proximal end 436 a of the cam 422 is matable with a distalend 438 a of the push rod 424, and a distal end 436 b of the cam 422 isadapted to engage and actuate the jaws 412. The proximal end 438 b ofthe push rod 424 is matable with a closure link assembly associated withthe drive housing 206 for moving the push rod 424 and the cam 422relative to the jaws 412.

The distal end 436 b of the cam 422 includes a camming channel ortapering recess formed therein for slidably receiving corresponding camtracks provided by the jaw members. In operation, the cam 422 isadvanced from a proximal position, in which the jaw members are spacedapart from one another, to a distal position, where the jaw members arecollapsed to a closed position. As the cam 422 is advanced over the jawmembers, the tapering recess at the distal end 436 b serves to push thejaw members toward one another, thereby crimping a surgical clip 416disposed therebetween.

FIG. 5 is an exposed isometric view of the surgical tool 200 of FIG. 2,according to one or more embodiments. The shroud or covering of thedrive housing 206 has been removed to reveal the internal componentparts. As illustrated, the surgical tool 200 may include a first drivegear 502 a, a second drive gear 502 b, and a third drive gear 502 c. Thefirst drive gear 502 a may be operatively coupled to (or extend from)the first drive input 306 a (FIG. 3) such that actuation of the firstdrive input 306 a correspondingly rotates the first drive gear 502 a.Similarly, the second and third drive gears 502 b,c may be operativelycoupled to (or extend from) the second and third drive inputs 306 b,c(FIG. 3), respectively, such that actuation of the second and thirddrive inputs 306 b,c correspondingly rotates the second and third drivegears 502 b,c, respectively.

The first drive gear 502 a may be configured to intermesh with a firstdriven gear 504 a, which is operatively coupled to the shaft 202. In theillustrated embodiment, the driven gear 504 a comprises a helical gear.In operation, rotation of the first drive gear 502 a about a first axiscorrespondingly rotates the first driven gear 504 a about a second axisorthogonal to the first axis to control rotation of the shaft 202 inclockwise and counter-clockwise directions based on the rotationaldirection of the first drive gear 502 a.

The second drive gear 502 b may be configured to intermesh with a seconddriven gear 504 b (partially visible in FIG. 5), and the third drivegear 502 c may be configured to intermesh with a third driven gear 504c. In the illustrated embodiment, the second and third drive and drivengears 502 b,c, 504 b,c comprise corresponding rack and pinioninterfaces, where the driven gears 504 b,c comprise the rack and thedrive gears 502 b,c comprise the pinion. Independent rotation of thesecond and third drive gears 502 b,c will cause the second and thirddriven gears 504 b,c, respectively, to translate linearly relative to(independent of) one another.

In at least one embodiment, actuation (rotation) of the third drive gear502 c will result in a surgical clip 416 (FIG. 4) being fed into thejaws 412. More particularly, the third driven gear 504 c may beoperatively coupled to the feedbar 418 (FIG. 4) and, upon rotation ofthe third drive gear 502 c in a first angular direction, the thirddriven gear 504 c will advance distally and correspondingly advance thefeedbar 418 a sufficient distance to fully advance a surgical clip intothe jaws 412. Rotation of the third drive gear 502 c may be preciselycontrolled by an electrical and software interface to deliver the exactlinear travel to the third driven gear 504 c necessary to feed a clip416 into the jaws 412.

Upon delivery of a clip into the jaws 412, or after a predeterminedamount of rotation of the third drive gear 502 c, rotation of the thirddrive gear 502 c is reversed in a second angular direction to move thethird driven gear 504 c linearly in a proximal direction, whichcorrespondingly moves the feedbar 418 proximally. This process may berepeated several times to accommodate a predetermined number of clipsresiding in the shaft 202.

Actuation of the second drive gear 502 b causes the jaws 412 to close orcollapse to crimp a surgical clip. More particularly, the second drivengear 504 b may be coupled to the proximal end 438 b (FIG. 4) of the pushrod 424 (FIG. 4) and, upon actuation of the second drive gear 502 b in afirst angular direction, the second driven gear 504 b will be advancedlinearly in a distal direction and correspondingly drive the push rod424 distally, which drives the cam 422 over the jaws 412 to collapse thejaw members and crimp a surgical clip positioned in the jaws 412. Once asurgical clip is successfully deployed, rotation of the second drivegear 502 b is reversed in the opposite angular direction to move thesecond driven gear 504 b in a proximal direction, which correspondinglymoves the push rod 424 and the cam 422 proximally and permits the jaws412 to open once again.

The processes of delivering a surgical clip into the jaws 412 andcollapsing the jaws 412 to crimp the surgical clip are not limited tothe actuation mechanisms and structures described herein. In alternativeembodiments, for example, the second and third driven gears 504 b,c mayinstead comprise capstan pulleys configured to route and translate drivecables within the shaft 202. In such embodiments, the drive cables maybe operatively coupled to one or more lead screws or other types ofrotating members positioned within the shaft 202 near the distal end andcapable of advancing the feedbar 418 to deliver a surgical clip into thejaws 412 and advancing the cam 422 to collapse the jaws 412 and crimpthe surgical clip.

FIG. 6 is an enlarged, isometric view of one example of the jaws 412 ofFIG. 4. As illustrated, the jaws 412 include a proximal portion 602 aand a distal portion 602 b. The proximal portion 602 a provides teeth604 for mating with corresponding teeth formed on the jaw retainer shaft406 (FIG. 4). Other techniques, however, can be used to mate the jaws412 to the jaw retainer shaft 406; e.g., a dovetail connection, amale-female connection, etc. Alternatively, the jaws 412 may beintegrally formed with the jaw retainer shaft 406.

The distal portion 602 b of the jaws 412 provides opposed first andsecond jaw members 606 a and 606 b movable relative to one another andadapted to receive a surgical clip (not shown) therebetween. In at leastone embodiment, the jaw members 606 a,b are biased to an open position,and a force is required to move the jaw members 606 a,b toward oneanother (i.e., collapse the jaws 412). Each jaw member 606 a,b caninclude a groove 608 (one partially shown in FIG. 6) formed on opposedinner surfaces thereof for receiving the legs of a surgical clip inalignment with the jaw members 606 a,b. Each jaw member 606 a,b can alsoinclude a cam track 610 formed thereon. The cam 422 (FIG. 4) may beconfigured to engage the jaw members 606 a,b at the cam tracks 610 andthereby urge (force) the jaw members 606 a,b to collapse toward oneanother. In the illustrated embodiment, the cam tracks 610 areessentially ramped features formed on a superior (upper) surface of eachjaw member 606 a,b. In other embodiments, however, the cam tracks 610may be formed and otherwise provided on the outer lateral sides of eachjaw member 606 a,b, without departing from the scope of the disclosure.

FIG. 7 is an enlarged isometric view of one example of the cam 422 ofFIG. 4, and FIG. 8 is an isometric view of one example of the push rod424 of FIG. 4. The cam 422 may be configured for slidably mating withand engaging the jaw members 606 a,b (FIG. 6). In at least oneembodiment, a proximal end 702 a of the cam 422 is matable with a distalend 802 (FIG. 8) of the push rod 424. As illustrated, the proximal end702 a of the cam 422 provides a female or keyed cut-out 704 (FIG. 7)formed therein to receive a male or key member 804 (FIG. 8) formed atthe distal end 802 of the push rod 424. As will be appreciated, the cam422 and the push rod 424 may alternatively be integrally formed with oneanother. The proximal end 802 of the push rod 424 can be adapted to mateto a closure link assembly for moving the push rod 424 and the cam 422relative to the jaws 412 (FIG. 6).

Referring to FIG. 7, the distal end 702 b of the cam 422 is adapted toengage and actuate the jaws 412 (FIG. 6). More specifically, in theillustrated embodiment, a camming channel or tapering recess 706 isformed or otherwise provided at the distal end 702 b of the cam 422.During actuation, the tapering recess 706 is configured to slidablyreceive the cam tracks 610 (FIG. 6) provided by the jaw members 606 a,b(FIG. 6), and further movement of the cam 422 relative to the jaws 412will urge the jaw members 606 a,b to collapse toward each other.

FIGS. 9A and 9B illustrate example operation of the cam 422 and the jaws412. In FIG. 9A, a surgical clip 902 has been previously advanced to thejaws 412. As illustrated, the legs 904 of the surgical clip 902 arereceived within the grooves 608 defined in the opposed inner surfaces ofthe jaw members 606 a,b, and the crown 906 (alternately referred to asthe “apex”) is positioned between the jaw members 606 a,b and pointsproximally.

To crimp the surgical clip 902, the cam 422 is advanced distally (i.e.,to the left in FIGS. 9A and 9B) relative to the jaws 412. In FIG. 9A,the cam 422 is shown in a proximal position, where the jaw members 606a,b are spaced apart from one another. As the cam 422 is advanceddistally over the jaw members 606 a,b, the tapering recess 706 receivesand slidingly engages the angled surfaces of the cam tracks 610, whichsimultaneously urges the jaw members 606 a,b to collapse toward oneanother and crimp the surgical clip 902. FIG. 9B shows the crimpedsurgical clip 902.

During distal movement of the cam 422, the jaw members 606 a,b act asindividual cantilever beams as they are urged toward one another by thecam 422. Because the jaw members 606 a,b act as cantilever beams, thedistal ends or “tips” of the jaw members 606 a,b come together first, atwhich point each jaw member 606 a,b is effectively converted into afixed-pinned beam, which increases the stiffness of the system. Asopposed pinned-pinned beams, the lateral force required to fully closethe jaw members 606 a,b along the length of the grooves 608 increasesdramatically. In some applications, for example, 70 lbf-80 lbf of forceis required to fully close the jaw members 606 a,b. Consequently, thisrequires more expensive and powerful actuators to move (actuate) the cam422 and necessitates more robust materials used to make the jaws 412,the cam 422, and other intervening structural elements that facilitatejaw 812 actuation.

According to embodiments of the present disclosure, robotic clipappliers (or alternately non-robotic clip appliers) may incorporateimproved jaws that eliminate distal tip-to-tip closure of itscorresponding jaw members. As described herein, the improved jaws may bedesigned to achieve parallel (or substantially parallel) closure betweenthe corresponding jaw members. As used herein, the term “substantiallyparallel” can refer to true relative parallelism between opposingmembers or near true relative parallelism, without departing from thescope of the disclosure. Eliminating tip-to-tip closure eliminates theneed to deflect the opposed jaw members between supported ends, whichmay prove advantageous in eliminating the additional reaction load fromthe opposing jaw member and minimizing jaw length. Moreover, substantialparallel closure between opposed jaw members may prove advantageous inreducing manufacturing costs. Conventional clip applier jaws, forexample, are typically manufactured of robust materials via stamping ormachining processes to accommodate the large forces required to fullyclose the jaws. Jaws capable of facilitating parallel closure of opposedjaw members, however, may require less force to fully close, whichallows the jaws to be manufactured of less expensive materials and vialess expensive manufacturing processes.

FIGS. 10A and 10B are isometric views of an example end effector 1002that may incorporate the principles of the present disclosure, accordingto one or more embodiments. The end effector 1002 may be similar in somerespects to the end effector 204 of FIG. 2 and, therefore, may beincorporated into the surgical tool 200 described herein above.Moreover, the end effector 1002 may comprise a clip applier having jaws1004 that are actuatable to collapse toward one another to crimp asurgical clip 1006. The jaws 1004 may be similar in some respects to thejaws 412 of FIG. 6 and may, in at least one embodiment, replace the jaws412 in any of the above-described embodiments.

FIGS. 10A and 10B illustrate progressive views of the end effector 1002during example operation. More specifically, FIG. 10A shows the jaws1004 in the open position, and FIG. 10B shows the jaws in the closedposition. Referring first to FIG. 10A, the end effector 1002 may includea housing 1008 (shown in dashed) having a proximal end 1010 a and adistal end 1010 b. The housing 1008 may at least partially surround mostof the component parts of the end effector. In some embodiments, thehousing 1008 may form part of and otherwise comprise an axial extensionof the outer tube 402 of FIG. 4. In other embodiments, however, thehousing 1008 may comprise an independent structure from the outer tube402. For example, in at least one embodiment the proximal end 1010 a maybe operatively coupled to an elongate shaft of a surgical tool, such asthe shaft 202 of the surgical tool 200 of FIG. 2. In other embodiments,however, the proximal end 1010 a may be operatively coupled to anarticulable wrist joint that enables the end effector 1002 and relatedjaws 1004 to articulate during operation.

As illustrated, the jaws 1004 comprise a two-piece assembly thatincludes opposing jaw members 1012 a and 1012 b. The jaw members 1012a,b extend out of or otherwise protrude from the distal end 1010 b ofthe housing 1008. Each jaw member 1012 a,b is an independent structurethat is movable relative to the other upon actuation to transition thejaws 1004 between the open and closed positions. As illustrated, eachjaw member 1012 a,b comprises an elongate body 1014 having a first orproximal end 1016 a and a second or distal end 1016 b. Surgical clips1006 (one shown) may be received between the jaw members 1012 a,b at ornear the distal end 1016 b for crimping. More specifically, surgicalclips 1006 may be fed into and otherwise received between opposed innersurfaces 1018 of the jaw members 1012 a,b provided at the distal end1016 b. In some embodiments, a groove 1020 may be defined on the innersurface 1018 of each jaw member 1012 a,b at the distal end 1016 b. Eachgroove 1020 may be configured to receive the opposing legs of thesurgical clip 1006 in alignment with the jaw members 1012 a,b. In otherembodiments, however, the grooves 1020 may be omitted and the surgicalclip 1006 may be maintained between the opposing inner surfaces 1018 viaan interference fit or the like.

In contrast to the design and function of conventional jaws (e.g., thejaws 412 of FIGS. 4, 6, and 9A), which commonly employ one-pieceopposing jaw members with a gap defined therebetween, the discrete andindividual jaw members 1012 a,b described herein allow the jaws 1004 toachieve parallel closure between the opposing inner surfaces 1018.Parallel closure of the opposing inner surfaces 1018 may proveadvantageous in reducing the amount of force required to collapse thejaw members 1012 a,b to the closed position.

As used herein, the phrase “parallel closure” refers to the relativeparallel disposition of the opposing inner surfaces 1018 of the jawmembers 1012 a,b throughout the entire range of motion as the jawmembers 1012 a,b move between open and closed positions. “Parallelclosure” is often used with respect to medical device end effectors andis desirable to minimize tissue damage due to non-uniform pressure ormilking (squeezing out) of tissue from between opposed jaw members.Because the jaw members 1012 a,b are separate and independent structuresthat are movable relative to one another during actuation, the innersurfaces 1018 are able to maintain a parallel or substantially parallelcorrelation (juxtaposition) while collapsing toward the closed positionand crimping the surgical clip 1006.

The end effector 1002 may further include an actuation mechanism 1022operatively coupled to the jaw members 1012 a,b and actuatable totransition the jaw members 1012 a,b between the open and closedpositions. As used herein, the phrase “operatively coupled” can refer toa direct or indirect coupling relationship between two structuralmembers. In the illustrated embodiment, the actuation mechanism 1022includes a dual-pulley assembly comprising a first or proximal pulley1024 a and a second or distal pulley 1024 b. The proximal and distalpulleys 1024 a,b may be rotatably mounted within the housing 1008 andare each rotatable about corresponding central axes A₁ and A₂,respectively. In some embodiments, the proximal and distal pulleys 1024a,b may reside in the same plane within the end effector 1002 (i.e.,coplanar), but may alternatively be arranged on different planes.

The proximal pulley 1024 a provides or otherwise defines a firsttransition pin 1026 a and a second transition pin 1026 b located onangularly opposite sides of the proximal pulley 1024 a. The firsttransition pin 1026 a extends from the proximal pulley 1024 a toslidably engage the first jaw member 1012 a, and the second transitionpin 1026 b extends from the proximal pulley 1024 a to slidably engagethe second jaw member 1012 b. More particularly, as illustrated, thefirst transition pin 1026 a may be received within a first or proximalslot 1028 a defined in the body 1014 of the first jaw member 1012 a, andthe second transition pin 1026 b may be received within a first orproximal slot 1030 a defined in the body 1014 of the second jaw member1012 b. As illustrated, the proximal slots 1028 a, 1030 a extendlongitudinally and otherwise parallel to a longitudinal axis of the endeffector 1002. As the jaws 1004 are actuated, the first and secondtransition pins 1026 a,b slidably translate within the correspondingslots 1022 a, 1030 a, respectively.

Similarly, the distal pulley 1024 b provides or otherwise defines afirst transition pin 1032 a and a second transition pin 1032 b locatedon angularly opposite sides of the distal pulley 1024 b. The firsttransition pin 1032 a extends from the distal pulley 1024 b to slidablyengage the first jaw member 1012 a, and the second transition pin 1032 bextends from the distal pulley 1024 b to slidably engage the second jawmember 1012 b. More particularly, as illustrated, the first transitionpin 1032 a is received within a second or distal slot 1028 b defined inthe body 1014 of the first jaw member 1012 a, and the second transitionpin 1032 b is received within a second or distal slot 1030 b defined inthe body 1014 of the second jaw member 1012 b. As illustrated, thedistal slots 1028 b, 1030 b extend longitudinally and otherwise parallelto the longitudinal axis of the end effector 1002. As the jaws 1004 areactuated, the first and second transition pins 1032 a,b slidablytranslate within the corresponding slots 1028 b, 1030 b, respectively.

While each jaw member 1012 a,b defines proximal and distal slots 1028a,b and 1030 a,b, respectively, it is contemplated herein to includeonly a single slot on each jaw member 1012 a,b. FIG. 10C, for example,shows an embodiment in which the proximal and distal slots 1028 a,b and1030 a,b of each jaw member 1012 a,b, respectively, are combined orotherwise merged to form a single slot 1031 into which the first andsecond transition pins 1026 a,b and 1032 a,b may extend and slidablyengage the corresponding jaw members 1012 a,b. Accordingly, thedepiction of the separate proximal and distal slots 1028 a,b and 1030a,b in each jaw member 1012 a,b in FIGS. 10A and 10B is merely forillustrative purposes and should not be considered limiting to thepresent disclosure.

Actuating the actuation mechanism 1022 causes the proximal and distalpulleys 1024 a,b to simultaneously rotate about their respective centralaxes A₁, A₂, and thereby transition the jaws 1004 between the open andclosed positions. In the illustrated embodiment, the proximal and distalpulleys 1024 a,b are operatively coupled with a closed-loop actuationbelt or cable 1034 wrapped or otherwise extending about each pulley 1024a,b in corresponding pulley grooves defined about the outer periphery ofeach pulley 1024 a,b. Consequently, rotation of one of the proximal anddistal pulleys 1024 a,b in a first angular direction X will cause theactuation cable 1034 to move and correspondingly rotate the other of theproximal and distal pulleys 1024 a,b in the same direction X, and viceversa. While the first angular direction X is shown in FIG. 10A as theclockwise direction, the first angular direction X may alternatively bethe counter-clockwise direction, without departing from the scope of thedisclosure.

The actuation mechanism 1022 may be configured to rotate the proximalpulley 1024 a to simultaneously rotate the distal pulley 1024 b andthereby cause actuation of the jaws 1004. In one embodiment, forexample, one or more drive cables 1036 (shown in dashed) may loop aroundthe proximal pulley 1024 a in a separate pulley groove defined about theouter periphery (or at another location) of the proximal pulley 1024 a.The drive cable(s) 1036 may extend to a drive housing (e.g., the drivehousing 206 of FIG. 2) and be operatively coupled to a drive input thatcauses longitudinal movement of the drive cable(s) 1036. In at least oneembodiment, for example, the drive cable(s) 1036 may be operativelycoupled to one or more drive cable capstans arranged within the drivehousing and rotation of the drive cable capstan(s) causes longitudinalmovement of the drive cable(s) 1036 and, consequently, rotation of theproximal pulley 1024 a. Moreover, in such embodiments, the drivecable(s) 1036 may be able to extend through an articulable wrist, ifincluded in a given surgical tool.

In other embodiments, however, the actuation mechanism 1022 may includea gearing arrangement or mechanism configured to engage and rotate theproximal pulley 1024 a. In such embodiments, for example, a drive shaft(not shown) may extend distally from a drive housing (e.g., the drivehousing 206 of FIG. 2) and may be operatively coupled to an actuatingmechanism or device at the drive housing and configured to causerotation of the drive shaft. In one embodiment, for example, the driveshaft may be operatively coupled to and otherwise extend from a helicalgear arrangement, similar to the first drive and driven gears 502 a, 504a of FIG. 5. A worm gear may be positioned at the distal end of thedrive shaft and may be engageable with the proximal pulley 1024 a.Accordingly, rotation of the drive shaft would correspondingly rotatethe worm gear and thereby drive rotation of the proximal pulley 1024 a.In embodiments with an articulable wrist, the drive shaft may be made ofa flexible material and capable of extending through the wrist.

While the actuation mechanism 1022 is described herein as beingconfigured to rotate the proximal pulley 1024 a to simultaneously rotatethe distal pulley 1024 b and thereby cause actuation of the jaws 1004,it is contemplated herein that the actuation mechanism 1022 mayalternatively be configured to rotate the distal pulley 1024 b tothereby rotate the proximal pulley 1024 a and cause actuation of thejaws 1004, without departing from the scope of the disclosure. In suchembodiments, the drive cable(s) 1036 or the gearing arrangementdescribed above may instead be operatively coupled to the distal pulley1024 b to effect actuation of the jaws 1004.

Moreover, while the actuation mechanism 1022 is described andillustrated herein as including both the proximal and distal pulleys1024 a,b, it is contemplated herein to include only one pulley (e.g.,the proximal pulley 1024 a), without departing from the scope of thedisclosure. In such embodiments, the drive cable(s) 1036 may beconfigured to rotate the proximal pulley 1024 a, which causes the firstand second transition pins 1026 a,b to slidably translate within thecorresponding slots 1022 a, 1030 a, respectively, and thereby collapsethe jaw members 1012 a,b toward each other.

Referring now to both FIGS. 10A and 10B, example operation of the endeffector 1002 is now provided. FIG. 10A shows the jaws 1004 in the openposition, and FIG. 10B depicts the jaws 1004 after having been moved(actuated) to a closed position.

In FIG. 10A, once the surgical clip 1006 is properly received betweenthe jaw members 1012 a,b at or near the distal end 1016 b, the actuationmechanism 1022 may be actuated to rotate the proximal pulley 1024 aabout its central axis A₁ in the first angular direction X. Rotating theproximal pulley 1024 a will drive the actuation cable 1034 linearly andthereby simultaneously rotate the distal pulley 1024 b about its centralaxis A₂ in the first angular direction X. As the proximal and distalpulleys 1024 a,b rotate, the first and second transition pins 1026 a,band 1032 a,b of each pulley 1024 a,b, respectively, will correspondinglyrotate and slidably translate within the corresponding proximal anddistal slots 1028 a,b and 1030 a,b defined in each jaw member 1012 a,b.Continued angular rotation of the proximal and distal pulleys 1024 a,bwill progressively draw the jaw members 1012 a,b toward each other asthe first and second transition pins 1026 a,b and 1032 a,b slidablytranslate within the proximal and distal slots 1028 a,b and 1030 a,b.

In some embodiments, the jaws 1004 may be stabilized againstlongitudinal movement as the jaw members 1012 a,b move toward or awayfrom each other during actuation. In one embodiment, for example, theend effector 1002 may provide, define, or otherwise include a stopmember 1038 (shown in dashed lines). The stop member 1038 may be fixedto or form an integral part of any stationary member or part of the endeffector 1002. For instance, the stop member 1038 may be fixed orotherwise removably coupled to an inner wall of the housing 1008, whichremains stationary during actuation. In the illustrated embodiment, thestop member 1038 is shown arranged at or near the proximal end 1016 a ofthe jaws 1004, but may alternatively be positioned at any other locationalong the length of the jaw members 1012 a,b. Moreover, while preventingthe jaw members 1012 a,b from moving longitudinally during actuation ofthe jaws 1004, the stop member 1038 may allow the jaw members 1012 a,bto move laterally relative to one another.

FIG. 10B shows the surgical clip 1006 crimped between the opposing jawmembers 1012 a,b as the jaw members 1012 a,b collapse toward each otherduring actuation. In some embodiments, the actuation mechanism 1022 maybe programmed or otherwise operated to rotate the proximal and distalpulleys 1024 a,b a predetermined or known angular distance that resultsin full crimping of the surgical clip 1006. Once the surgical clip 1006is crimped, the actuation mechanism 1022 may be reversed to move the jawmembers 1012 a,b back to the open position in preparation for receivinganother surgical clip.

Relative movement of the opposing jaw members 1012 a,b allows the planarinner surfaces 1018 of each jaw member 1012 a,b to approach each otherin a parallel or substantially parallel trajectory, and thereby providesa simultaneous and uniform crimping of the surgical clip 1006. Comparedto conventional clip applier jaws, the presently described jaws 1004 mayprove advantageous for a variety of reasons. Conventional jaws have jawmembers that act as cantilever beams as they are forced together duringactuation. This results in the distal ends or tips of the jaw memberstouching first during actuation. Once the tips touch, the jaw membersare effectively converted into continuous metal beams supported at eachend instead of having a free end. As a result, a great deal ofadditional force is required to deform the middle of the jaw members toachieve full collapse of the jaws. Testing has shown that upwards of70-80 lbf of force is required to fully collapse the jaw members ofconventional jaws to crimp a surgical clip. The required elevated forcenecessitates more powerful actuators and more robust materials andmanufacturing methods so that the jaws may withstand such forces.

In contrast, the presently described jaw members 1012 a,b compriseseparate structures that allow the jaws 1004 to achieve parallel closureand uniform crimping of the surgical clip 1006. Parallel closuredramatically reduces the force required to collapse the jaw members 1012a,b. In some applications, for example, the required force to adequatelycollapse (crimp) the surgical clip 1006 would be an order of magnitudeor less than conventional jaws. This advantageously allows smalleractuators to be used to collapse the jaws 1004. Moreover, this allowsthe jaws 1004 to be made of less-expensive materials and manufacturedthrough less-expensive manufacturing processes. In some embodiments, forexample, the jaws 1004 may be made of injection molded plastic. In otherembodiments, the jaws 1004 may be made of a metal and molded through ametal injection molding process. In yet other embodiments, the jaws 1004may be made of a plastic or a metal and manufactured via an additivemanufacturing process (e.g., 3D printing). In even further embodiments,the jaws 1004 may be made of a metallic base with a plastic overmolding,without departing from the scope of the disclosure.

The novel features of the jaws 1004 may also prove advantageous inhelping to minimize the length and overall size of the jaws 1004. Morespecifically, since less force is required to collapse the jaws 1004,less jaw length is required to help deflect a cantilever beam-type jawmember. Consequently, the length of the jaws 1004 can be reduced, whichmay prove advantageous in minimizing the length of a clip applier pastan articulation joint or wrist, for example. Another advantage of theseparate jaw members 1012 a,b is that surgical clips need not beintroduced into the jaw members 1012 a,b out of plane, i.e., from adifferent elevation within the end effector 1002. Rather, the surgicalclips can be advanced distally in the same plane as the jaw members 1012a,b and pass between the space that separates the jaw members 1012 a,b.

FIGS. 11A and 11B are partial cross-sectional views of another exampleend effector 1102 that may incorporate the principles of the presentdisclosure, according to one or more embodiments. The end effector 1102may be similar in some respects to the end effector 1002 of FIGS.10A-10B and therefore may also be incorporated into the surgical tool200 described herein above. Moreover, the end effector 1102 may comprisea clip applier having jaws 1104 that are actuatable to collapse towardone another to crimp a surgical clip 1106.

The jaws 1104 may be similar in some respects to the jaws 1004 of FIGS.10A-10B. For instance, similar to the jaws 1004, the jaws 1104 may alsocomprise a two-piece assembly that includes opposing jaw members 1108 aand 1108 b that are independent structures movable relative to the otherupon actuation. Surgical clips 1106 may be fed into and otherwisereceived between opposed inner surfaces 1110 of the jaw members 1108 a,band, in some embodiments, a groove 1112 may be defined on the innersurface 1110 of each jaw member 1108 a,b to receive the opposing legs ofthe surgical clip 1006. The discrete and individual jaw members 1108 a,bdescribed herein allow the jaws 1104 to achieve parallel closure betweenthe opposing inner surfaces 1110.

The end effector 1102 may further include an actuation mechanism 1114that may be actuatable to transition the jaw members 1108 a,b betweenthe open and closed positions. The actuation mechanism 1114 may compriseany device or mechanism capable of or configured to move (collapse) thejaw members 1108 a,b toward each other and thereby crimp the surgicalclip 1106 disposed therebetween. As illustrated, the actuation mechanism1114 may include a jaw pulley 1116, a mechanical linkage 1117operatively coupled to the jaw pulley 1116, and a linear drive 1120operatively coupled to the mechanical linkage 1117. Rotation of the jawpulley 1116 causes actuation of the mechanical linkage 1117, which, inturn, cause actuation of the linear drive 1120, which operates tocollapse and open the jaw members 1108 a,b.

More specifically, the jaw pulley 1116 may be rotatably mounted to anaxle 1122 arranged within the housing 1008. A drive cable 1124 may berouted around the jaw pulley 1116 to cause rotation of the jaw pulley1116. The drive cable 1124 may extend from a drive housing (e.g., thedrive housing 206 of FIG. 2) and may be operatively coupled to acorresponding actuating mechanism or device positioned within the drivehousing and configured to cause longitudinal translation of the drivecable 1124. In one embodiment, for example, the drive cable 1124 may beoperatively coupled to one or more capstan pulleys. In otherembodiments, the drive cable 1124 may be operatively coupled andotherwise extend from one or more translatable driven gears. In yetother embodiments, the drive cable 1124 may be operatively coupled toany combination of capstan pulley and driven gear, without departingfrom the scope of the disclosure.

The mechanical linkage 1117 can comprise any mechanical apparatus orconfiguration configured to convert the rotational movement of the jawpulley 1116 into an axial load applied to the linear drive 1120. In someembodiments, for example, the mechanical linkage 1117 may comprise aU-joint, and rotation of the jaw pulley 1116 may actuate the U-joint tocause linear (axial) movement of the linear drive 1120 to move the firstand second jaw members 1108 a,b between the open and closed positions.In other embodiments, the mechanical linkage 1117 may comprise one ormore cables threaded around a corner and wrapped directly onto a capstanarranged in axial alignment with linear drive. In such embodiments,rotation of the jaw pulley 1116 may drive the one or more cables torotate the capstan, and thereby cause linear (axial) movement of thelinear drive 1120 to move the first and second jaw members 1108 a,b.

In yet other embodiments, as illustrated, the mechanical linkage 1117may comprise a bevel gear assembly 1118. The bevel gear assembly 1118may include a beveled drive gear 1126 a coupled to or forming part ofthe jaw pulley 1116 and a corresponding beveled driven gear 1126 bpositioned to be driven (rotated) by the drive gear 1126 a. In someembodiments, the linear drive 1120 may comprise a threaded linear drivethat includes a worm gear 1128 operatively coupled to or extending fromthe driven gear 1126 b, and a threaded gear plate 1130 that provides afemale threading 1132 configured to threadably mate with or engage thehelical threading defined on the worm gear 1128.

Referring now to both FIGS. 11A and 11B, example operation of the endeffector 1102 is now provided. FIG. 11A shows the jaws 1104 in the openposition, and FIG. 11B depicts the jaws 1004 after having been moved(actuated) to the closed position.

Once the surgical clip 1106 is properly received between the jaw members1108 a,b, the actuation mechanism 1114 may be actuated to commencecollapsing the jaw members 1108 a,b to crimp the surgical clip 1106.Triggering the actuation mechanism 1114 causes the drive cable 1124 tobe translated (moved). As the drive cable 1124 translates, the jawpulley 1116 and the drive gear 1126 a are correspondingly rotated, andthe drive gear 1126 a transmits a rotational load to the driven gear1126 b, which correspondingly rotates in a first angular direction, asindicated by the arrow A (FIG. 11B). As the driven gear 1126 b rotates,the helical threading on the worm gear 1128 interacts with the femalethreading 1132 on the gear plate 1130 and thereby urges (drives) thegear plate 1130 in a first linear direction, as indicated by the arrow B(FIG. 11B).

As illustrated, the jaw members 1108 a,b comprise independent orseparate plate-like structures that are configured to move laterallyrelative to one another to collapse and crimp the surgical clip 1106. Aswith the jaws 1004 of FIGS. 10A-10B, the jaws 1104 may be prevented frommoving longitudinally during actuation. Each jaw member 1108 a,b mayprovide and otherwise define one or more angled slots 1134 that extendat an angle offset from a longitudinal axis Y of the end effector 1102.While two angled slots 1134 are shown on each jaw member 1108 a,b, itwill be appreciated that more or less than two may be employed, withoutdeparting from the scope of the disclosure. The angled slots 1134 ofeach jaw member 1108 a,b may extend at equal but opposite angles. Moreparticularly, the slots 1134 of the first jaw member 1104 may extend ata positive angle relative to the longitudinal axis Y, while the slots1134 of the second jaw member 1106 may extend at a negative angle of thesame magnitude relative to the longitudinal axis Y. As a result,depending on the axial direction, the angled slots 1134 diverge from orconverge toward each other along the longitudinal axis Y.

As illustrated, one or more transition pins 1136 extend from the gearplate 1130 and through the angled slots 1134 of each jaw member 1108 a,bwhen the jaw members 1108 a,b are installed in the end effector 1102. Asthe worm gear 1128 rotates, the gear plate 1130 correspondingly moves inthe first linear direction B (FIG. 11B), which simultaneously moves thetransition pins 1136 in the same direction. The transition pins 1136slidingly engage the angled slots 1134 and, because of the oppositelyangled configuration of the angled slots 1134, the transition pins 1136will urge the jaw members 1108 a,b to transition (move) laterally withrespect to each other, as indicated by the oppositely directed arrows C(FIG. 11B). As the jaw members 1108 a,b collapse toward each other inthe direction C, the surgical clip 1106 will be crimped or crushedtherebetween.

The jaw members 1108 a,b may be re-opened to receive another un-crimpedsurgical clip by reversing the foregoing procedure. More specifically,the drive cable 1124 may be translated (moved) in a second drivingdirection opposite the first driving direction, which will rotate thejaw pulley 1116 and the drive gear 1126 a in the opposite directionrelative to the axle 1122, and the driven gear 1126 b willcorrespondingly rotate in a second angular direction opposite the firstangular direction A (FIG. 11B). Rotating the driven gear 1126 b in thesecond angular direction will unthread the worm gear 1128 from the gearplate 1130, which urges (drives) the gear plate 1130 in a second lineardirection opposite the first linear direction B (FIG. 11B). As the gearplate 1130 moves in the second linear direction, the transition pins1136 also move in the same direction within and slidingly engaging theangled slots 1134, which urges the jaw members 1108 a,b to separate fromeach other in a direction opposite the direction C.

In some embodiments, the actuation mechanism 1114 may further include asecond jaw pulley 1138 rotatably mounted to the axle 1122 and a seconddrive cable 1140 may be routed around the second jaw pulley 1138 tocause rotation thereof. The second drive cable 1140 may be similar tothe first drive cable 1124 and, therefore, may extend from a drivehousing (e.g., the drive housing 206 of FIG. 2) and may be operativelycoupled to a corresponding actuating mechanism or device positionedwithin the drive housing and configured to cause longitudinaltranslation of the second drive cable 1140. In at least one embodiment,actuation of the second drive cable 1140 may act on the mechanicallinkage 1117 (e.g., the bevel gear assembly 1118) and thereby causeactuation of the jaws 1104. In such embodiments, the first drive cable1124 may be actuated to close the jaws 1104, and the second drive cable1140 may be actuated in the opposite direction to re-open the jaws 1104.The longitudinal movement of the drive cables 124, 1140 may be preciselycontrolled to collapse and open the jaw members 1108 a,b to knownmagnitudes.

The independent or separate plate-like structures of the jaw members1108 a,b may exhibit similar advantages as described above withreference to the jaw members 1012 a,b of FIGS. 10A-10B, and thereforewill not be provided again.

FIG. 12A is a partial isometric view of another example end effector1202 that may incorporate the principles of the present disclosure,according to one or more embodiments. The end effector 1202 may besimilar in some respects to the end effectors 1002 and 1102 of FIGS.10A-10B and 11A-11B, respectively, and therefore may also beincorporated into the surgical tool 200 of FIG. 2 described herein.Moreover, the end effector 1202 may comprise a clip applier having jaws1204 that are actuatable to collapse toward one another to crimp asurgical clip (not shown) therebetween.

Similar to the jaws 1004 and 1104 of FIGS. 10A-10B and 11A-11B,respectively, the jaws 1204 may also comprise a two-piece assembly thatincludes opposing jaw members 1206 a and 1206 b that are independentstructures movable relative to the other upon actuation to achieveparallel closure. Surgical clips may be fed into and otherwise receivedbetween opposed inner surfaces 1208 of the jaw members 1206 a,b, and insome embodiments, a groove 1210 may be defined on the inner surface 1110of each jaw member 1206 a,b and configured to receive the opposing legsof the surgical clip.

The end effector 1202 may further include an actuation mechanism 1212that may be actuatable to transition the jaw members 1206 a,b betweenthe open and closed positions. The actuation mechanism 1212 may compriseany device or mechanism capable of or configured to move (collapse) thejaw members 1206 a,b toward each other and thereby crimp the surgicalclip disposed therebetween. In the illustrated embodiment, the actuationmechanism 1212 includes an actuation plate 1214 movably positioned (atleast partially) within the housing 1008 and configured for longitudinaltranslation relative to the housing 1008 and the jaws 1204.

To facilitate longitudinal movement, the actuation plate 1214 may beoperatively coupled to a drive mechanism (not shown) configured to movethe actuation plate 1214 back and forth in the longitudinal directionsD. In some embodiments, for example, a portion of the actuation plate1214 may extend proximally to a drive housing (e.g., the drive housing206 of FIG. 2) and may be operatively coupled to an actuating mechanismor device at the drive housing and configured to longitudinallytranslate the actuation plate 1214. In other embodiments, the actuationplate 1214 may be operatively coupled to a drive shaft that extends fromthe drive housing and is actuatable to facilitate longitudinal movementof the actuation plate 1214. In embodiments with an articulable wrist,the drive shaft may be made of a flexible material and capable ofextending through the wrist.

As it translates longitudinally, the actuation plate 1214 may slidinglyengage the jaw members 1206 a,b and thereby cause the jaws 1204 to movebetween the open and closed positions, depending on the longitudinaltranslation direction D. More specifically, the actuation plate 1214 mayinclude a transition pin 1216 that extends (e.g., downwardly) from theactuation plate 1214 and is received within corresponding slots 1218defined in each jaw member 1206 a,b. The slots 1218 each provide aprofile configured to urge the jaw members 1206 a,b to move laterallyrelative to the other as the transition pin 1216 traverses the slots1218.

FIGS. 12B and 12C are top views of the jaws 1204 in the open and closedpositions, respectively. As illustrated, the slots 1218 defined in eachjaw member 1206 a,b provide an angled profile and the transition pin1216 (shown in dashed) extends into each slot 1218. As the transitionpin 1216 moves distally within the slots 1218, the transition pin 1216slidingly engages the angled profile and urges the jaw members 1206 a,bto collapse toward each other. The jaws 1204 are moved back to the openposition by moving the transition pin 1216 proximally within the slots1218.

FIG. 12D is a side view of the actuation plate 1214, according to one ormore embodiments. As illustrated, the transition pin 1216 extendsdownward from a bottom surface 1220 of the actuation plate 1214 toenable the transition pin 1216 to be received within the aligned slots1218 (FIGS. 12A-12C) of the jaw members 1206 a,b (FIGS. 12A-12C). Thetransition pin 1216 may be coupled to the actuation plate 1214 orotherwise form an integral extension thereof. In other embodiments,however, the actuation plate 1216 may be configured to be positionedbeneath the jaw members 1206 a,b in the end effector 1202 (FIG. 12A). Insuch embodiments, the transition pin 1216 may instead extend upward froma top surface of the actuation plate 1214.

It will be appreciated that the illustrated configuration of theactuation plate 1214 is only one example design thereof. Those skilledin the art will readily appreciate that several variations to the designmay be employed without departing from the scope of the disclosure.Accordingly, the actuation plate 1214 is shown merely for illustrativepurposes and should not be considered limiting to the presentdisclosure.

FIG. 12E is an isometric view of the end effector 1202 with the jaws1204 moved to the closed position. As illustrated, the actuation plate1214 has moved distally relative to the body 1008 and the jaws 1204. Asthe actuation plate 1214 moves distally, the transition pin 1216slidingly translates within the corresponding slots 1218 defined in thejaw members 1206 a,b, and the angled profile of the slots 1218 urges thejaw members 1206 a,b to collapse toward each other.

Embodiments disclosed herein include:

A. An end effector for a surgical clip applier that includes a housing,jaws that extend past a distal end of the housing and include opposedfirst and second jaw members each comprising an independent structuremovable relative to the other, the first jaw member defining a firstinner surface and the second jaw member defining a second inner surfaceopposite the first inner surface, and an actuation mechanism operativelycoupled to the jaw members to move the jaws between an open position anda closed position, wherein the first and second inner surfaces remainsubstantially parallel to each other as the jaws move between the openand closed positions.

B. A surgical clip applier that includes a drive housing, an elongateshaft that extends from the drive housing, and an end effector arrangedat a distal end of the elongate shaft. The end effector includes ahousing, jaws that extend past a distal end of the housing and includeopposed first and second jaw members each comprising an independentstructure movable relative to the other, the first jaw member defining afirst inner surface and the second jaw member defining a second innersurface opposite the first inner surface, and an actuation mechanismoperatively coupled to the jaw members to move the jaws between an openposition and a closed position, wherein the first and second innersurfaces remain substantially parallel to each other as the jaws movebetween the open and closed positions.

C. A method of operating a surgical clip applier that includespositioning the surgical clip applier adjacent a patient for operation,the surgical clip applier including a drive housing, an elongate shaftthat extends from the drive housing, and an end effector arranged at adistal end of the elongate shaft, the end effector including a housing,and jaws that extend past a distal end of the housing and includeopposed first and second jaw members each comprising an independentstructure movable relative to the other. The method further includingactuating the surgical clip applier to move the first and second jawmembers from an open position to a closed position, wherein the firstjaw member provides a first inner surface and the second jaw memberprovides a second inner surface opposite the first inner surface,maintaining the first and second inner surfaces substantially parallelto each other as the first and second jaw members move to the closedposition, and crimping a surgical clip disposed between the first andsecond jaw members.

Each of embodiments A, B, and C may have one or more of the followingadditional elements in any combination: Element 1: wherein the actuationmechanism comprises a first pulley rotatably mounted within the housingand providing a first transition pin slidably engageable with the firstjaw member and a second transition pin slidably engageable with thesecond jaw member, and one or more drive cables operatively coupled tothe first pulley and longitudinally movable to rotate the first pulleyand thereby transition the jaws between the open and closed positions.Element 2: further comprising a second pulley rotatably mounted withinthe housing distal to the first pulley and providing a first transitionpin slidably engageable with the first jaw member and a secondtransition pin slidably engageable with the second jaw member, and aclosed-loop actuation cable wrapped about the first and second pulleys,wherein rotation of the first pulley correspondingly rotates the secondpulley to transition the jaws between the open and closed positions.Element 3: wherein the first transition pin of the first pulley and thefirst transition pin of the second pulley are each received within oneor more slots defined in the first jaw member, and wherein the secondtransition pin of the first pulley and the second transition pin of thesecond pulley are each received within one or more slots defined in thesecond jaw member. Element 4: wherein the actuation mechanism comprisesa jaw pulley rotatably mounted to an axle arranged within the housing, adrive cable routed around the jaw pulley and longitudinally movable torotate the jaw pulley, a mechanical linkage operatively coupled to thejaw pulley, and a linear drive having a gear plate operatively coupledto the mechanical linkage, wherein rotation of the jaw pulley actuatesthe mechanical linkage and thereby causes actuation of the linear drive,which operates to move the first and second jaw members between the openand closed positions. Element 5: further comprising one or more firstangled slots defined in the first jaw member and extending at a positiveangle relative to a longitudinal axis of the end effector, one or moresecond angled slots defined in the second jaw member and extending at anegative angle relative to the longitudinal axis, wherein the negativeangle is of a same magnitude as the positive angle, and one or moretransition pins extending from the gear plate and through the one ormore first and second angled slots, wherein actuation of the lineardrive moves the gear plate in a linear direction and correspondinglymoves the one or more transition pins to slidingly engage the one ormore first and second angled slots and thereby urges the first andsecond jaw members laterally with respect to each other. Element 6:wherein the actuation mechanism comprises an actuation plate movablypositioned within the housing and adapted for longitudinal translationrelative to the jaws, and a transition pin extending from the actuationplate and received within corresponding slots defined in each jawmember, wherein, as the transition pin traverses the corresponding slotsin a longitudinal direction, the first and second jaw members are movedlaterally relative to the other. Element 7: wherein the jaws are made ofmetal, plastic, or metal overmolded with plastic, and wherein the jawsare manufactured by one of machining, stamping, molding and an additivemanufacturing process. Element 8: further comprising a groove defined ineach of the first and second inner surfaces for receiving legs of asurgical clip.

Element 9: further comprising an articulable wrist joint interposing theend effector and the elongate shaft. Element 10: wherein the actuationmechanism comprises a first pulley rotatably mounted within the housingand providing a first transition pin slidably engageable with the firstjaw member and a second transition pin slidably engageable with thesecond jaw member, and one or more drive cables operatively coupled tothe first pulley and extending to the drive housing, wherein the one ormore drive cables are longitudinally movable from the drive housing torotate the first pulley and thereby transition the jaws between the openand closed positions. Element 11: further comprising a second pulleyrotatably mounted within the housing distal to the first pulley andproviding a first transition pin slidably engageable with the first jawmember and a second transition pin slidably engageable with the secondjaw member, and a closed-loop actuation cable wrapped about the firstand second pulleys, wherein rotation of one of the first pulleycorrespondingly rotates the second pulley to transition the jaws betweenthe open and closed positions. Element 12: wherein the actuationmechanism comprises a jaw pulley rotatably mounted to an axle arrangedwithin the housing, a drive cable routed around the jaw pulley andlongitudinally movable to rotate the jaw pulley, a mechanical linkageoperatively coupled to the jaw pulley, and a linear drive having a gearplate operatively coupled to the mechanical linkage, wherein rotation ofthe jaw pulley actuates the mechanical linkage and thereby causesactuation of the linear drive, which operates to move the first andsecond jaw members between the open and closed positions. Element 13:further comprising one or more first angled slots defined in the firstjaw member and extending at a positive angle relative to a longitudinalaxis of the end effector, one or more second angled slots defined in thesecond jaw member and extending at a negative angle relative to thelongitudinal axis, wherein the negative angle is of a same magnitude asthe positive angle, and one or more transition pins extending from thegear plate and through the one or more first and second angled slots,wherein actuation of the linear drive moves the gear plate in a lineardirection and correspondingly moves the one or more transition pins toslidingly engage the one or more first and second angled slots andthereby urges the first and second jaw members laterally with respect toeach other. Element 14: wherein the actuation mechanism comprises anactuation plate movably positioned within the housing and adapted forlongitudinal translation relative to the jaws, wherein the actuationplate is actuatable from the drive housing, and a transition pinextending from the actuation plate and received within correspondingslots defined in each jaw member, wherein, as the transition pintraverses the corresponding slots in a longitudinal direction, the firstand second jaw members are moved laterally relative to the other.

Element 15: wherein actuating the surgical clip applier is preceded bydistally advancing the surgical clip in a same plane as the jaw membersand thereby traversing a space that separates the first and second jawmembers, and positioning the surgical clip between the first and secondinner surfaces. Element 16: wherein actuating the surgical clip appliercomprises triggering operation of an actuation mechanism that includes apulley rotatably mounted within the housing and providing a firsttransition pin slidably engageable with the first jaw member and asecond transition pin slidably engageable with the second jaw member,and one or more drive cables operatively coupled to the pulley andextending from the drive housing, and longitudinally moving the one ormore drive cables and thereby rotating the first pulley andcorrespondingly moving the first and second jaw members from the openposition to the closed position. Element 16: wherein actuating thesurgical clip applier comprises triggering operation of an actuationmechanism that includes an actuation plate having a transition pinextending therefrom and received within corresponding slots defined ineach jaw member, longitudinally moving the actuation plate relative tothe first and second jaw members, and moving the first and second jawmembers laterally relative to the other as the transition pin slidablytranslates within each slot.

By way of non-limiting example, exemplary combinations applicable to A,B, and C include: Element 1 with Element 2; Element 2 with Element 3;Element 4 with Element 5; Element 10 with Element 11; Element 12 withElement 13; and Element 16 with Element 17.

Therefore, the disclosed systems and methods are well adapted to attainthe ends and advantages mentioned as well as those that are inherenttherein. The particular embodiments disclosed above are illustrativeonly, as the teachings of the present disclosure may be modified andpracticed in different but equivalent manners apparent to those skilledin the art having the benefit of the teachings herein. Furthermore, nolimitations are intended to the details of construction or design hereinshown, other than as described in the claims below. It is thereforeevident that the particular illustrative embodiments disclosed above maybe altered, combined, or modified and all such variations are consideredwithin the scope of the present disclosure. The systems and methodsillustratively disclosed herein may suitably be practiced in the absenceof any element that is not specifically disclosed herein and/or anyoptional element disclosed herein. While compositions and methods aredescribed in terms of “comprising,” “containing,” or “including” variouscomponents or steps, the compositions and methods can also “consistessentially of” or “consist of” the various components and steps. Allnumbers and ranges disclosed above may vary by some amount. Whenever anumerical range with a lower limit and an upper limit is disclosed, anynumber and any included range falling within the range is specificallydisclosed. In particular, every range of values (of the form, “fromabout a to about b,” or, equivalently, “from approximately a to b,” or,equivalently, “from approximately a-b”) disclosed herein is to beunderstood to set forth every number and range encompassed within thebroader range of values. Also, the terms in the claims have their plain,ordinary meaning unless otherwise explicitly and clearly defined by thepatentee. Moreover, the indefinite articles “a” or “an,” as used in theclaims, are defined herein to mean one or more than one of the elementsthat it introduces. If there is any conflict in the usages of a word orterm in this specification and one or more patent or other documentsthat may be incorporated herein by reference, the definitions that areconsistent with this specification should be adopted.

As used herein, the phrase “at least one of” preceding a series ofitems, with the terms “and” or “or” to separate any of the items,modifies the list as a whole, rather than each member of the list (i.e.,each item). The phrase “at least one of” allows a meaning that includesat least one of any one of the items, and/or at least one of anycombination of the items, and/or at least one of each of the items. Byway of example, the phrases “at least one of A, B, and C” or “at leastone of A, B, or C” each refer to only A, only B, or only C; anycombination of A, B, and C; and/or at least one of each of A, B, and C.

What is claimed is:
 1. An end effector for a surgical clip applier,comprising: a housing; jaws that extend past a distal end of the housingand include opposed first and second jaw members each comprising anindependent structure movable relative to the other, the first jawmember defining a first inner surface and the second jaw member defininga second inner surface opposite the first inner surface; and anactuation mechanism operatively coupled to the jaw members to move thejaws between an open position and a closed position, the actuationmechanism including: a pulley rotatably mounted within the housing; afirst transition pin extending from the pulley and slidably engageablewith the first jaw member at a slot defined in the first jaw member; anda second transition pin extending from the pulley and slidablyengageable with the second jaw member at a slot defined in the secondjaw member, wherein the first and second inner surfaces remainsubstantially parallel to each other as the jaws move between the openand closed positions.
 2. The end effector of claim 1, wherein theactuation mechanism further includes one or more drive cablesoperatively coupled to the pulley and longitudinally movable to rotatethe pulley and thereby transition the jaws between the open and closedpositions.
 3. The end effector of claim 1, wherein the pulley is a firstpulley and the actuation mechanism further includes: a second pulleyrotatably mounted within the housing distal to the first pulley andproviding a first transition pin slidably engageable with the first jawmember and a second transition pin slidably engageable with the secondjaw member; and a closed-loop actuation cable wrapped about the firstand second pulleys, wherein rotation of the first pulley correspondinglyrotates the second pulley to transition the jaws between the open andclosed positions.
 4. The end effector of claim 3, wherein the firsttransition pin of the first pulley and the first transition pin of thesecond pulley are each received within the slot defined in the first jawmember, and wherein the second transition pin of the first pulley andthe second transition pin of the second pulley are each received withinthe slot defined in the second jaw member.
 5. The end effector of claim3, wherein the first transition pins of the first and second pulleys areeach received within a separate slot defined in the first jaw member,and wherein the second transition pins of the first and second pulleysare each received within a separate slot defined in the second jawmember.
 6. The end effector of claim 1, wherein the jaws are made ofmetal, plastic, or metal overmolded with plastic, and wherein the jawsare manufactured by one of machining, stamping, molding and an additivemanufacturing process.
 7. The end effector of claim 1, furthercomprising a groove defined in each of the first and second innersurfaces for receiving legs of a surgical clip.
 8. A surgical clipapplier, comprising: a drive housing; an elongate shaft that extendsfrom the drive housing; an end effector arranged at a distal end of theelongate shaft, the end effector including: a housing; and jaws thatextend past a distal end of the housing and include opposed first andsecond jaw members each comprising an independent structure movablerelative to the other, the first jaw member defining a first innersurface and the second jaw member defining a second inner surfaceopposite the first inner surface; and an actuation mechanism operativelycoupled to the jaw members to move the jaws between an open position anda closed position, the actuation mechanism including: a pulley rotatablymounted within the housing; a first transition pin extending from thepulley and slidably engageable with the first jaw member at a slotdefined in the first jaw member; and a second transition pin extendingfrom the pulley and slidably engageable with the second jaw member at aslot defined in the second jaw member, wherein the first and secondinner surfaces remain substantially parallel to each other as the jawsmove between the open and closed positions.
 9. The surgical clip applierof claim 8, further comprising an articulable wrist joint interposingthe end effector and the elongate shaft.
 10. The surgical clip applierof claim 8, wherein the actuation mechanism further includes one or moredrive cables operatively coupled to the pulley and extending to thedrive housing, wherein the one or more drive cables are longitudinallymovable from the drive housing to rotate the pulley and therebytransition the jaws between the open and closed positions.
 11. Thesurgical clip applier of claim 8, wherein the pulley is a first pulleyand the actuation mechanism further includes a second pulley rotatablymounted within the housing distal to the first pulley and providing afirst transition pin slidably engageable with the first jaw member and asecond transition pin slidably engageable with the second jaw member;and a closed-loop actuation cable wrapped about the first and secondpulleys, wherein rotation of one of the first pulley correspondinglyrotates the second pulley to transition the jaws between the open andclosed positions.
 12. The surgical clip applier of claim 11, wherein thefirst transition pins of the first and second pulleys are each receivedwithin the slot defined in the first jaw member, and wherein the secondtransition pins of the first and second pulleys are each received withinthe slot defined in the second jaw member.
 13. The surgical clip applierof claim 11, wherein the first transition pins of the first and secondpulleys are each received within a separate slot defined in the firstjaw member, and wherein the second transition pins of the first andsecond pulleys are each received within a separate slot defined in thesecond jaw member.
 14. A method of operating a surgical clip applier,comprising: positioning the surgical clip applier adjacent a patient foroperation, the surgical clip applier including a drive housing, anelongate shaft that extends from the drive housing, and an end effectorarranged at a distal end of the elongate shaft, the end effectorincluding: a housing; and jaws that extend past a distal end of thehousing and include opposed first and second jaw members each comprisingan independent structure movable relative to the other, wherein thefirst jaw member provides a first inner surface and the second jawmember provides a second inner surface opposite the first inner surface;actuating an actuation mechanism operatively coupled to the first andsecond jaw members to move the first and second jaw members from an openposition to a closed position, the actuation mechanism including: apulley rotatably mounted within the housing; a first transition pinextending from the pulley and slidably engageable with the first jawmember at a slot defined in the first jaw member; and a secondtransition pin extending from the pulley and slidably engageable withthe second jaw member at a slot defined in the second jaw member;maintaining the first and second inner surfaces substantially parallelto each other as the first and second jaw members move to the closedposition; and crimping a surgical clip disposed between the first andsecond jaw members.
 15. The method of claim 14, wherein actuating theactuation mechanism is preceded by: distally advancing the surgical clipin a same plane as the jaw members and thereby traversing a space thatseparates the first and second jaw members; and positioning the surgicalclip between the first and second inner surfaces.
 16. The method ofclaim 14, wherein the actuation mechanism further includes one or moredrive cables operatively coupled to the pulley and extending from thedrive housing, and wherein actuating the actuation mechanism furthercomprises: longitudinally moving the one or more drive cables andthereby rotating the pulley and correspondingly moving the first andsecond jaw members from the open position to the closed position.